Gastroenterology & Hepatology — Flashcards

Flashcard 71: What is the preferred diuretic in ascites secondary to liver cirrhosis?

Answer: • Aldosterone antagonist (spironolactone)

Flashcard 72: In extensive disease of UC where rectal aminosalicylates are not sufficient, what should be added?

Answer: • Oral Aminosalicylates

Flashcard 73: What type of acid-base disturbance does diarrhoea cause?

Answer: Normal anion gap metabolic acidosis

Flashcard 74: What is Haematochezia?

Answer: • Passage of fresh blood from the rectum, often occurs with lower GI bleeding

Flashcard 75: What else can differentiate an Upper GI bleed verses a lower GI bleed, other than melaena?

Answer: • High urea levels

Flashcard 76: What would cause pain when, or shortly after, eating?

Answer: • Gastric Ulcer

Flashcard 77: When is Oral Vancomycin with IV metronidazole given in C.Diff?

Answer: • When it is a life-threatening infection. Confirmed C.Diff with hypotension, partial/complete ileus, toxic megacolon

Flashcard 78: What is Acute Mesenteric Ischaemia typically caused by, and what do patients classically have in their history?

Answer: • Typically caused by an embolism resulting in occlusion of an artery which supplies the small bowel • Classically patients have a Hx of Atrial Fibrillation

Flashcard 79: What are the common Full Blood Count (FBC) / Peripheral Smear findings in Celiac Disease?

Answer: • Iron deficiency anemia (Microcytic) • Vitamin B12/Folate deficiency anemia (Macrocytic) • Functional hyposplenism (Target cells, Howell-Jolly bodies) • Thrombocytosis (reactive)

Extra: Celiac disease most commonly causes iron deficiency anemia (microcytic) due to malabsorption in the duodenum. It can also cause macrocytic anemia (B12/Folate deficiency) or a mixed picture (normocytic). Functional hyposplenism is a recognized association, which may show Howell-Jolly bodies and target cells on a peripheral smear.

Flashcard 80: Courvoisier's law states that in the presence of painless obstructive jaundice, a palpable gallbladder is...

Answer: A palpable gallbladder is unlikely to be due to gallstones (more likely to be due to malignancy, e.g., pancreatic cancer).